Operative treatment for esophageal varices is usually left for last and to preserve life. Most operative treatment are aggressive and can cause many complications. The main operative treatment done is either to decrease portal hypertension or to remove the part liable to form varices. The most commonly done intervention is TIPS which is short for “Transjugular Intrahepatic Portosystemic Shunt”. This involves forming a shortcut for the portal venous blood to go to the systemic blood without passing by the liver. This procedure usually accelerates brain damage in cirrhosis and is used as a bridging therapy to liver transplantation.
Transection of the distal esophagus is another therapeutic option that includes the removal of the lower third of the esophagus since it is the part most liable for varices and bleeding. This is especially effective in severe cases, but the rate of complications is high.